Astellas wins NICE backing for Xtandi in prostate cancer

England’s health guidance body says drug can be used in advanced cases of the disease

Astellas received positive news in the UK with the publication of draft guidance advocating the use of Xtandi as a treatment for prostate cancer on the NHS.

The National Institute for Health and Care Excellence (NICE) gave an initial recommendation that the oral oncology drug should be able in England and Wales to treat men with hormone relapsed metastatic prostate cancer.

"There are few treatments available for patients at this stage in their cancer so we are very pleased that we are able to produce draft guidance recommending enzalutamide,” said Professor Carole Longson, director of the Centre for Health Technology Evaluation at NICE.

As per the drug's licence in Europe, the guidance covers the use of Xtandi (enzalutamide) only if a patient has receiver prior treatment with a docetaxel-containing chemotherapy and their disease has progressed.

Astellas also needs to provide Xtandi through a patient access scheme, meaning the Japanese company would cover part of the drug's cost. An entire course of treatment is estimated to be £25,269 based on the £2,734.67 price per pack of 112 capsules and the mean length of treatment of 8.5 months.

As part of its cost-effectiveness assessment of the Xtandi, NICE took into account the recent recommendation for Janssen's rival prostate cancer drug Zytiga (abiraterone).

NICE backed Zytiga last year after a troubled review period, recommending the drug in combination with prednisone or prednisolone to treat castration-resistant metastatic prostate cancer that has progressed on, or after, docetaxel.

However, Xtandi offers some advantages over Janssen's drug, according to NICE, including the capability to be taken on a full stomach, making it more convenient for patients. Xtandi can also help to control the cancer longer because there is no need to reduce the dose to prevent liver toxicity, as with Zytiga.

NICE also noted that the drugs work in different ways; Xtandi by blocking receptors on the surface of cells to block the action of testosterone and Zytiga by blocking the CYP17 enzyme to stop the body from producing testosterone.

There is now a consultation period, after which NICE will issue final guidance on Xtandi.